Database for Rehabilitation Measures - Most are FREE!

In my Facebook feed, HeartSpace Physical Therapy for Children , shared a link to a database of over 200 rehabilitation measures.  Many of them are FREE and available in PDF format.  It doesn't get any easier than that for a last minute assessment.  Some of the resources are for the pediatric population so it is definitely worth it to look it over and bookmark your favorites.  There are so many to choose from and it will take a little time to go through the whole list.  The Rehabilitation Measures Database can be found here  http://www.rehabmeasures.org/rehabweb/allmeasures.aspx?PageView=Shared 

I would like to highlight one of the measures each week that are suitable for the pediatric population.  I will go in alphabetical order so it is manageable.

The first one suitable for pediatrics is the 10 Meter Walk Test.



Purpose:   Assesses walking speed in meters per second over a short duration

Age Range:  Preschool Child: 2-5 years; Child: 6-12 years; Adolescent: 13-17 years; Adult: 18-64 years; Elderly adult: 65+

Abilities:  Can use an assistive device is used consistently and documented.  Can not use if individual requires physical assistance to ambulate

Equipment: stopwatch, clear pathway for 10 meters, pen and paper

Test-Retest Reliability: Children with Neuromuscular Disease: (Pirpiris, 2003; n = 29; mean age = 11.5 (3.5) years (6-16), Children with Neuromuscular Disease) Excellent test-retest reliability (ICC = 0.91)

PDF version of test: http://www.rehabmeasures.org/PDF%20Library/10%20Meter%20Walk%20Test%20Instructions.pdf

Reference:  Rehab Measures 10 Meter Walk Test. Retreived from the web on 2/13/15 at ww.rehabmeasures.org/Lists/RehabMeasures/DispForm.aspx?ID=901&Source=http%3A%2F%2Fwww%2Erehabmeasures%2Eorg%2Frehabweb%2Fallmeasures%2Easpx%3FPageView%3DShared.

[subscribe2]



 

Title: Data Tracking Forms for School Based Occupational and Physical Therapy
By: Your Therapy Source Inc

Summary: Download of 7 data collection forms for monitoring progress
in occupational and physical therapy in the school setting

FIND OUT MORE AT http://yourtherapysource.com/datatracking.html

Development of Locomotor Skills - Walking

Walking is the first in a series of blog posts on locomotor skills.   Children can learn how to walk at a young age but to become an efficient walker the child's abilities must progress.

Here are the "steps" it takes to develop advanced walking:

1.  The child's stride length increases.  This is due to greater application of force and
greater leg extension at push-off.   From a biomechanical perspective, the child will grow taller therefore increasing leg length resulting in a longer stride.

2. Instead of a flat footed gait pattern, a heel to toe pattern emerges increasing range of motion.

3. The child moves from a position a pointing the toes out to a more neutral position.

4.  The base of support narrows making walking mostly in the anterior posterior planes (front to back) versus sagittal planes (right to left).

5.  The child progresses to extending the knee at heel strike and again at the push off phase of gait.

6. The pelvis rotates while the leg flexes and extends to allow the full range of leg motions and oppositional movement of the upper and lower body segments.

7. Balance improves.

8.  Forward trunk inclination is reduced.

9. Coordination of opposite arm swing with the movement of the legs.

All of the above mentioned steps are dependent upon the child's muscle strength, balance, coordination, body awareness and biomechanics.

The next time you are evaluating a student's walking pattern don't forget to review the above steps to determine where in the gait cycle the child may need to improve.

Stay tuned for the next post in the locomotor series - the development of running.

Reference:  Haywood, K. M., & Getchell N. (2001) Life span motor development. In J.P. Wright, and M. Feld, et al (Eds.), Development of human locomotion (pp. 121-142).Champaign, IL: Human Kinetics

[subscribe2]

Gait Analysis and Visual Input

The Journal of Physical Therapy Science published research on the effects of the modulation of optic flow speed on gait parameters in children with hemiplegic cerebral palsy.  Optic flow is the pattern of motion perceived at the retina, which specifies the direction of locomotion and provides vital feedback concerning an individual's regulation of walking velocity.

Gait analysis was completed on 10 children with hemiplegic cerebral palsy under 3 different conditions of optic flow speed: slow, normal, and fast optic flow speed. The children walked across the walkway of a GAITRite system, while watching a virtual reality screen, and walking velocity, cadence, stride length, step length, single support time, and double support time were recorded.

The results indicated the following:

• fast optic flow speed (2 times the normal speed) significantly increased walking velocity, cadence, normalized step length, base of support, and single support cycle of both lower limbs.


• the slow optic flow speed (0.25 times the normal speed) yielded a significantly decreased walking velocity, cadence, normalized step length, base of support, and single support cycle for both lower limbs.

The researchers concluded that: gait training involving modulation of the optic flow speed is feasible and suitable for resolving abnormal gait patterns in children with hemiplegic cerebral palsy.

I am wondering how this could be applied in regular therapy sessions?  Any ideas of off the shelf virtual reality to vary visual input speed?  All I can come up with is filming some video yourself with varying walking speeds?  The WiiFit has a Basic Run but the speed of the objects going by you is based on your own speed.  Any suggestions?

Reference:  Hyungwon Lim, PhD, PT. Effect of the modulation of optic flow speed on gait parameters in children with hemiplegic cerebral palsy. J Phys Ther Sci. 2014 Jan;26(1):145-8. doi: 10.1589/jpts.26.145. Epub 2014 Feb 6.

Full text article at https://www.jstage.jst.go.jp/article/jpts/26/1/26_jpts-2013-312/_pdf.

 

Auditory Stimulation versus NDT Effects on Gait

Clinical Rehabilitation will be publishing research that compared the gait of two groups of adults with cerebral palsy following auditory stimulation or neurodevelopmental treatment (NDT).   Thirteen individuals received gait training with NDT and 15 individuals received gait training with rhythmic auditory stimulation.  The training sessions with 3 times per week for 3 weeks.     Rhythmic auditory stimulation combined a metronome beat set to the individual's cadence with rhythmic cuing from a live keyboard and traditional neurodevelopmental treatment was provided.

Results indicated the following:

1. Temporal gait measures showed that rhythmic auditory stimulation significantly increased cadence, walking velocity, stride length, and step length.

2. Kinematic data indicated that anterior tilt of the pelvis and hip flexion during a gait cycle was significantly reduced following rhythmic auditory stimulation.

3. Gait deviation index also showed modest improvement in cerebral palsy patients treated with rhythmic auditory stimulation.

4. Neurodevelopmental treatment showed that internal and external rotations of hip joints were significantly improved.

5. Rhythmic auditory stimulation showed aggravated maximal internal rotation in the transverse plane.

The authors concluded that gait training with rhythmic auditory stimulation or NDT produced different effects on gait patterns of adults with cerebral palsy.

Have you ever tried gait training with auditory stimulation in children with cerebral palsy?  Would be curious to hear your experiences.

Reference:   Kim SJ, Kwak EE, Park ES, Cho SR. Differential effects of rhythmic auditory stimulation and neurodevelopmental treatment/Bobath on gait patterns in adults with cerebral palsy: a randomized controlled trial. Clin Rehabil. 2012 Feb 3. [Epub ahead of print]

Interesting New Treadmill

Came across this new treadmill they are using in the Netherlands for adult rehabilitation.  Images are projected onto the treadmill as obstacles or targets.  This would be great in pediatrics.  Check out this You Tube video.